At an assembly during my first week of medical school, one of the institution’s venerable deans took to the podium to announce that our class marked a turning point in the school’s history: nearly half of us were female.

My classmates and I were unimpressed.

For while our genders might have been mixed, it hadn’t taken us long to realize that on paper we were remarkably alike. We had similar college majors, grade point averages and scores on the standardized Medical College Admissions Test, or MCAT. Most of us came from relatively comfortable backgrounds, spent summers working in a lab and had parents heavily vested in our education. Two of us, while not related, even shared a relatively uncommon last name.

The few classmates from underrepresented groups in medicine — African-Americans, Latinos and Native Americans — stood out.

“This is medical school,” a classmate remarked. “It’s not about who you are. It’s about how well you do in science and the MCATs.”

That perspective has long been assumed to be a guiding principle of medical education. But now, as the country’s universities and courts are struggling once again to define diversity and admissions policies, two perspective pieces in The New England Journal of Medicine reveal that admissions policies have been quietly but radically changing in a handful of medical schools. And those changes have yielded surprisingly successful results.

Each year, on average, medical school admissions committees sift through some 4,500 applications for each entering class of 100 to 200 or more students. The first cut is most fierce; of those thousands of applicants, only a few hundred are invited for an interview. From there, roughly one in every four of those interviewed will be accepted.

Medical schools have traditionally relied on undergraduate science grades and the MCAT to decide which applicants to interview. They based this approach in part on numerous studies that found good correlations between science G.P.A. and MCAT scores and subsequent medical school performance.

But more recent studies have also revealed that MCAT scores are significantly influenced by a student’s race, gender and socioeconomic background. Observers have noted, too, that a large and lucrative industry has developed around MCAT preparation; and students who could not afford the substantial tuition or time required by such prep courses were finding themselves at a disadvantage.

Continue reading...